Alveolar proteinosis with hypersensitivity pneumonitis: A new clinical phenotype

作者：Verma Hema; Nicholson Andrew G; Kerr Keith M; Dempsey Owen J; Gibbs Allen R; Campbell Ian; Black Fiona; Rassl Doris; Rice Alexandra J; Renzoni Elizabeth A; Wells Athol U; Hansell David M^*

来源：Respirology, 2010, 15(8): 1197-1202.

DOI：10.1111/j.1440-1843.2010.01848.x

• diagnostic imaging
• histopathology
• hypersensitivity pneumonitis
• interstitial lung disease
• pulmonary alveolar proteinosis

Background and objective: The aim of the present study was to report the features of five patients with concurrent histopathological features of pulmonary alveolar proteinosis (PAP) and hypersensitivity pneumonitis (HP) and their high-resolution CT (HRCT) appearances.
Methods: Patients with histopathological features of both HP and PAP on surgical lung biopsy referred for tertiary review were retrospectively identified. The pathology and HRCT images were semi-quantitatively scored to evaluate the relative contribution to HP and PAP.
Results: Five patients had histopathological features of HP and PAP but had varied HRCT appearances. All had imaging features of PAP to a varying degree with two patients also showing characteristics of HP but three patients had ill-defined thickened interlobular septa, not typical of either disease.
Conclusions: We describe the coexistence of PAP and HP in five patients and discuss possible linkages between these two distinct pathologies.

• 出版日期2010-11